Administration of insulin via insulin pens has been widely accepted by patients and providers in the ambulatory setting, and in recent years, the inpatient acute care setting as well. Insulin pens offer several advantages over the traditional insulin vial and syringe. A greater degree of comfort at the injection site and ease of use for the patient provide a better experience. Further, a dial on the insulin pen enables dose selection and makes dose accuracy more precise. Also, a cover or shield provides protection of the needles and helps reduce contamination and prevent needle sticks of healthcare personnel. Further, initiation and education on the use of the insulin pen, during the acute care hospital visit, improves the transition to use in the home/ambulatory setting. Numerous studies have demonstrated that the use of insulin pens in the acute care setting is beneficial to both patients and providers.
However, the use of insulin pens in the acute care setting has also created problems that are unique to this care venue and are not necessarily observed in the ambulatory setting. For example, managing blood glucose control in the hospital setting is more fluid and dynamic due to rapidly changing patient conditions. Consequently, frequent dose changes are common and can require multiple insulin products and dosing regimens. Some regimens require different dosing schemas even with the same insulin product. These complexities have resulted in numerous medication errors and patient safety concerns. The use of barcode medication administration (BCMA) applications has reduced the incidence of insulin administration errors. However, current systems still depend on the clinician manually confirming or keying in the dose of insulin administered. There is no direct integration between the insulin pen administration device (pen or syringe) and the BCMA application.
Further, when using BCMA applications, multiple dosing regimens with the same insulin product require multiple labels and barcodes to be placed on a single insulin pen. This results in confusion for the clinician and requires each new pen to be re-labeled with multiple labels.
Insulin pens are designed for single patient use; however, there have been numerous reports of insulin pens being shared between patients in the hospital setting resulting in cross-contamination and infection control concerns. This problem is frequently attributed to poor practices by healthcare providers.
Other solutions available in the ambulatory setting have attempted to add a processor unit to the inulin pen itself. This provides dosing regimen information to the end user. However, these insulin pen administration devices do not address the multiple regimens that are often required in the hospital setting, do not prevent the clinician from administering the same syringe to multiple patients, and do not integrate directly with BCMA and electronic health record (EHR) applications.